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A thrombus in the heart is a common complication of cardiovascular pathologies. Statistics indicate that 43% of people who died from myocardial infarction had a blood clot in the heart cavity. Intracardiac thrombosis is a dangerous condition that can lead to death or disability of a person.
Depending on the constituent elements, a blood clot in the heart can be of the following types:
White (gray) thrombus. It is made up of platelets that form outgrowths that are shaped like corals. Such a thrombus is dry and crumbling. Its favorite localization site is the cusps of the heart valves and the space between the trabecular muscles.
Red blood clot It is represented by a large number of erythrocytes, in its pure form it is rare in the heart, it is mainly formed in the veins.
Mixed thrombus consists of erythrocytes and platelets. Such a clot has a head, neck and tail. This type of thrombus is often found in the cavities of the heart.
Tumor thrombus, which develops against the background of the spread of metastases by malignant neoplasms. The tumor thrombus grows in the direction of blood flow and in some cases reaches the right atrium.
Septic thrombus can form on the cusps of the heart valves in acute ulcerative endocarditis. Such a thrombus is a carrier of infection.
By itself, a blood clot is a blood clot that is attached to the walls of the heart muscle. It is generally accepted that a blood clot in the heart is a pathology that develops mainly in the elderly. In fact, 38,8% of cases are actually diagnosed in women and men over the age of 70. However, WHO indicates that the number of patients aged 35-50 years with diagnosed intracardiac thrombi is increasing every year. Therefore, it is so important to understand exactly what mechanisms contribute to the process of thrombus formation in the heart, how this pathology manifests itself and how to avoid it.
Causes of a blood clot in the heart
Modern medicine considers a blood clot in the heart as a multifactorial condition. This means that several reasons can provoke its appearance at once.
These include:
Placement of a venous catheter.
Congenital heart disease, ischemic heart disease. In this case, blood clots most often form on the left atrial appendage, or on the walls of the heart muscle.
Postponed myocardial infarction in 60-65% of cases leads to the formation of a blood clot in the heart.
In 5-10% of cases, rheumatic heart disease becomes the cause of the formation of an intracardiac thrombus.
The danger is arrhythmia with left atrial fibrillation.
Postponed septic endocarditis, rheumatic endocarditis. In this case, blood clots form on the cusps of the aortic valve or on the leaflets of the mitral valve.
The presence of a valve prosthesis in the heart.
Cardiomyopathy is the cause of the formation of a cardiac thrombus in 5% of cases.
Atherosclerotic changes in the vessels. This pathology causes the formation of a parietal thrombus in the aorta, in large arterial trunks that extend from the aorta.
Pathological changes in the walls of the heart muscle.
Blood flow disorders.
Increased blood viscosity.
Carrying defective genes that determine the tendency to thrombophilia.
In 4,7% of cases, blood clots in the heart can form due to the presence of a tumor in the body.
The following categories of citizens are at risk for increased formation of a blood clot in the heart:
Smokers.
Pregnant women and women in the early postpartum period.
Women taking hormonal contraceptives.
Obese people.
People leading a sedentary lifestyle.
People who abuse alcohol and coffee.
Patients undergoing abdominal surgery.
Hypertension.
Symptoms of a blood clot in the heart
Symptoms of a motionless blood clot in the heart for a long period of time may be absent. In some cases, this is manifested by tachycardia and the appearance of shortness of breath. In this case, shortness of breath occurs even when a person is at rest. All this time, the thrombus will be in the heart in a stationary state.
If the thrombus in the heart is mobile and moves freely in its cavity, then this will be accompanied by the following symptoms:
Cardiopalmus. Patients compare this feeling with the movement of a foreign body that is located inside the chest.
Blueing of the skin.
Increased sweating.
Dizziness.
Loss of consciousness or fainting.
Weakening of the pulsation of the radial artery.
Thrombosis of the left atrium is combined with the development of gangrene of the fingers and with a sharp drop in blood pressure. At the same time, the patient himself begins to suffocate.
If a thrombus bursts in the right atrium, then this situation leads to pulmonary thromboembolism. As a result, the person dies.
The following signs may indicate the presence of a blood clot in the heart:
Treatment with antiarrhythmic drugs does not bring the desired effect.
The patient develops pulmonary hypertension.
Medicines do not reduce pain in the heart.
However, only a doctor can make an accurate diagnosis, based on a number of studies.
Danger of a blood clot in the heart
A blood clot in the heart, provided it is detached, can lead to the development of a heart attack of the kidney, brain, and heart itself. There is also a risk of gangrene of the intestines and limbs. The incidence of these complications varies. So, gangrene of the legs is most often observed, which happens in 70-75% of cases. Cerebral infarction with separation of a cardiac thrombus occurs in 10% of cases.
If a detached blood clot is additionally a carrier of bacterial flora, then this is hello to a septic infarction of those organs where it enters. In the future, this always entails rapid purulent fusion of tissues and the development of an abscess. In this regard, the danger is infective endocarditis, as an etiological factor affecting the formation of a cardiac thrombus.
Further prognosis of developing complications depends on how large the thrombus was, as well as on the area of necrosis and its location. If the femoral artery is blocked, accompanied by gangrene of the leg, then death can be avoided. A good prognosis for survival can be made with thromboembolism by a cardiac thrombus of a branch of the renal or splenic artery.
Even the smallest thrombus that has entered the middle cerebral artery is of great danger in terms of the death of the patient.
Diagnosis of a blood clot in the heart
Diagnosis of intracardiac thrombosis is based on a thorough history of the clinical course of the disease. However, without an instrumental examination, it is impossible to confirm the presence of a blood clot in the heart.
In this regard, the most informative are the following methods:
Echocardiodopleographic examination (transesophageal ECHO-CG and transthoracic ECHO-CG).
Transesophageal ECHO-KG, which has almost 100% diagnostic value.
Auxiliary methods that make it possible to suggest the presence of a thrombus in the heart are: scintigraphy, which allows you to determine the degree of filling of the myocardium with blood, dopplerography, which measures blood flow velocity and heart pressure. It is also possible to conduct an MRI, which makes it possible to determine the presence of a heart tumor, the state of its tissues, and the quality of its functioning. The earlier concomitant cardiovascular diseases are detected, the higher the likelihood that the patient’s life will be saved.
Treatment of a blood clot in the heart
Medical therapy with the appointment of drugs is the leading method of treatment of uncomplicated thrombus in the heart. The patient is prescribed drugs that help dissolve blood clots. However, in some cases, it is not possible to do without surgical intervention.
The choice of treatment method remains with the specialist. This largely depends on the location of the thrombus, on the severity of the clinical picture, on the results of the tests.
If during the examination it was found that the patient has one or more small parietal blood clots, then it is reasonable to resort to conservative therapy. In this case, blood-thinning drugs, thrombolytic drugs, antiplatelet agents are prescribed.
Surgical removal of a thrombus
The operation is always associated with a number of risks and complications. Therefore, it is prescribed to patients in life-threatening situations. Surgery is indicated for patients diagnosed with a spherical or pedunculated thrombus that can lead to sudden death.
A blood clot in the heart can be removed in the following ways:
Endoscopic thrombectomy. All manipulations on the heart are carried out using an endoscope, which is inserted into the auricles.
Heart bypass with the use of equipment that replaces his work at the time of surgery.
Stenting. At the same time, to extract a thrombus, expansion of the coronary vessels using a special metal tube is required.
In the postoperative period, patients are prescribed antiplatelet agents for a long time, which reduces the risk of re-formation of blood clots.
Prevention of a blood clot in the heart
If a person is at risk for the formation of an intracardiac thrombus, then he must follow the following recommendations:
Stick to a diet, excluding from your diet products – sources of cholesterol. First of all, these are fried and fatty foods.
Drink at least 2 liters of water per day to prevent an increase in blood viscosity.
Lead a healthy lifestyle.
Quit smoking and alcohol abuse.
Go in for sports (do morning exercises, spend more time outdoors, take walks, etc.).
[Video] Cardiovascular surgeon, phlebologist Abasov M. M. – Products that thin blood clots: